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Exendin-4 has been shown to cross the blood-brain barrier (BBB) at high doses in mice [20], and exenatide demonstrates the fastest rates of brain influx compared to GLP-1 receptor agonists lixisenatide, liraglutide, and semaglutide [21]

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This rate does not exceed what would be expected as background flare activity in a lupus cohort, even without any new medication

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